Chapter 16 Flashcards
(217 cards)
1
Q
The incidence of bleeding associated with nasotracheal intubation can be reduced by:
A
lubricating the tip of the tube with a water-soluble gel.
2
Q
The cricothyroid membrane is the ideal site for making a surgical opening into the trachea because:
A
no important structures lie between the skin covering the cricothyroid membrane and the airway.
3
Q
Paralytic medications exert their effect by:
A
functioning at the neuromuscular junction and relaxing the muscle by impeding the action of acetylcholine.
4
Q
Assessment of a spontaneously perfusing patient’s ETCO2 reveals small capnographic waveforms and a reading of 22 mm Hg. Which of the following does this indicate?
A
Hyperventilation.
5
Q
When ventilating a patient with facial injuries, it is most important to:
A
be alert for changes in ventilation compliance.
6
Q
Which of the following structures is most critical to visualize during orotracheal intubation?
A
Epiglottis
7
Q
Which of the following clinical findings would be significant in a patient experiencing respiratory distress?
A
Fever of 102.5 degrees Fahrenheit
8
Q
The lowest portion of the pharynx that opens into the larynx anteriorly and the esophagus posteriorly is the:
A
laryngopharynx.
9
Q
When the King LT airway is properly placed, the distal cuff seals the:
A
Esophagus
10
Q
A study using data from 40 states demonstrated an overall prehospital ET intubation success rate of:
A
85.3%
11
Q
The King LT-D airway features a:
A
Curved tube with a ventilation port located between two inflatable cuffs
12
Q
After you have intubated an apneic patient with chest trauma, your partner is auscultating breath sounds and tells you that breath sounds are faint on the right side of the chest. You should:
A
suspect that the patient has a pneumothorax on the right side of the chest.
13
Q
After obtaining a peak expiratory flow reading of 200 mL, you administered one bronchodilator treatment to a 21-year-old woman with an acute episode of expiratory wheezing. The next peak flow reading is 400 mL. You should:
A
recognize that the patient’s condition has improved.
14
Q
Before performing orotracheal intubation, it is most important for the paramedic to:
A
wear gloves and facial protection.
15
Q
When performing nasotracheal intubation, you should preform the nasotracheal tube by bending it in a:
A
Circle.
16
Q
Which of the following is a nondepolarizing neuromuscular blocking agent?
• Midazolam
• Atropine sulfate
• Succinylcholine chloride
• Vecuronium bromide
A
Succinylcholine chloride
17
Q
A construction worker fell approximately 15 feet and landed on his head. He is semiconscious. His respiratory rate is 14 breaths/min with adequate depth. Further assessment reveals blood draining from his nose. You should:
A
administer oxygen via nonrebreathing mask and continue your assessment.
18
Q
In contrast to a curved laryngoscope blade, a straight laryngoscope blade is designed to:
A
extend beneath the epiglottis and lift it up.
19
Q
When properly positioned, the tip of the laryngeal mask airway is at the:
A
Entrance of the esophagus.
20
Q
Which of the following statements regarding anemia is correct?
A
Anemia results in a decreased ability of the blood to carry oxygen.
21
Q
When obtaining a peak expiratory flow rate for a patient with acute bronchospasm, you should:
A
Perform the test three times and take the best rate of the three readings.
22
Q
A length-based resuscitation tape measure can be used to determine the most appropriate size of bag-mask device for pediatric patients who weigh up to:
A
34 kg
23
Q
Incising the cricothyroid membrane horizontally will:
A
Minimize the risk of damaging the thyroid gland.
24
Q
Which of the following conditions will cause an increase in the circulating levels of carbon dioxide in the blood?
A
Lactic acidosis.
25
Because the high-pressure ventilator used with needle cricothyrotomy would cause an increase in intrathoracic pressure, which of the following could result?
Barotrauma
26
Fentanyl (Sublimaze) is a:
Narcotic analgesic
27
Face-to-face intubation may be performed in which of the following situations?
When a seated patient suddenly becomes unconscious and apneic.
28
An airway obstruction secondary to a severe allergic reaction:
Requires specific and aggressive treatment.
29
Assessment of a patient in respiratory distress reveals capnographic waveforms that resemble a shark fin. What should you suspect?
Bronchospasm
30
The physical act of moving air into and out of the lungs is called:
Ventilation
31
Intrapulmonary shunting is defined as:
the return of unoxygenated blood to the left side of the heart.
32
A 66-year-old woman is found to be unresponsive and apneic. Her carotid pulse is weak and rapid. When ventilating this patient, you should deliver:
each breath over 1 second at a rate of 10 breaths/min.
33
The main disadvantage of the LMA is that it:
does not provide protection against aspiration.
34
An intubated 33-year-old man is becoming agitated and begins moving his head around. Your estimated time of arrival at the hospital is 15 minutes. You should:
Administer a sedative medication.
35
Which of the following patients would require positive-pressure ventilation?
•Semiconscious 39-year-old man with shallow chest wall movement, cyanosis, and bradypnea
•Conscious 36-year-old man with difficulty breathing, symmetrical chest rise and fall, and flushed skin
•Conscious 41-year-old woman with early inspiratory crackles
•Conscious 46-year-old woman with wheezing and rhonchi
Semiconscious 39-year-old man with shallow chest wall movement, cyanosis, and bradypnea
36
What is the cuff volume of a King LT airway with a green connector?
35 mL
37
In contrast to a needle cricothyrotomy, a surgical cricothyrotomy:
enables the paramedic to provide greater tidal volume.
38
The King airway is contraindicated in patients:
With known esophageal disease.
39
A 50-year-old woman presents with acute respiratory distress while eating. Upon your arrival, you note that she is conscious, coughing, and wheezing between coughs. Further assessment reveals that her skin is pink and moist. In addition to transporting her to the hospital, you should:
Encourage her to cough and closely monitor her condition.
40
Which of the following statements regarding the automatic transport ventilator (ATV) is correct?
The paramedic can control an apneic patient's minute volume with accuracy when using an ATV.
41
CPAP is not appropriate for patients with:
Slow, shallow respiratory effort.
42
When suctioning a patient's stoma, you should:
Insert the catheter until resistance is felt
43
After inserting an oropharyngeal airway in an unresponsive woman, the patient begins to gag. You should:
Remove the airway and have suction ready.
44
The BURP maneuver usually involves applying backward, upward, and rightward pressure to the:
Lower third of the thyroid cartilage
45
The most common complication associated with nasotracheal intubation is:
Bleeding.
46
Product literature states that the LMA should only be used in patients who are:
Fasting
47
A 6.0-mm ET tube can be passed through which size LMA?
3 or 4
48
An increasing peak expiratory flow reading in a patient with respiratory distress suggests that the patient is:
Respond to bronchodilator therapy.
49
The pressure relief valve on an automatic transport ventilator may lead to unrecognized hypoventilation in patients with which of the following conditions?
Airway obstruction
50
Patients with laryngectomies commonly develop mucus plugs in their stoma because:
They do not possess an efficient cough.
51
Patients with a partial laryngectomy:
are called partial neck breathers because they breathe through both a stoma and the nose and mouth.
52
Two attempts to ventilate an unconscious 10-year-old boy have been unsuccessful. You should next:
Perform chest compressions.
53
After inserting the ET tube between the vocal cords, you should:
inflate the distal cuff with 5 to 10 mL of air.
54
If you insert the ET tube into the patient's left nostril, you should:
rotate the tube 180 degrees as its tip enters the nasopharynx.
55
A mouth-opening width of less than how many inches indicates a potentially difficult airway?
2
56
A 40-year-old man fell 20 feet from a tree while trimming branches. Your assessment reveals that he is unresponsive. You cannot open his airway effectively with the jaw-thrust maneuver. You should:
Carefully open his airway with the head tilt-chin lift maneuver
57
When performing nasotracheal intubation, you should use an ET tube that is:
1 to 1.5mm smaller than you would use for orotracheal intubation
58
When using a stethoscope with the head removed to determine maximum airflow during nasotracheal intubation, place the stethoscope tubing in the proximal end of the ET tube at approximately:
1 inch.
59
A patient with a suppressed cough mechanism:
Is at serious risk for aspiration.
60
Diazepam and midazolam provide which of the following therapeutic effects?
Sedative
61
Which of the following is a characteristic of a depolarizing neuromuscular blocking agent?
• Hypokalemia
• Hyperkalemia
• Tachycardia
• Bradycardia
Bradycardia
62
Capnography can serve as an indicator of:
Chest compression effectiveness.
63
With regard to intubation difficulty, neck mobility problems are commonly associated with:
Elderly patients.
64
Most of the complications caused by intubation-induced hypoxia:
Are subtle and occur gradually.
65
A Bourdon-gauge oxygen flowmeter:
Reduces the high pressure in the oxygen cylinder to a safe pressure.
66
When two paramedics are ventilating an apneic patient with a bag-mask device, the paramedic not squeezing the bag should:
Maintain an adequate mask-to-face seal.
67
Which of the following findings is most significant in a patient with acute respiratory distress?
Prior ICU admission for the same problem
68
Which of the following abnormal respiratory patterns suggest brain injury or cerebral anoxia?
Agonal respirations
69
Supplemental oxygen is indicated for any patient with:
Respiratory distress
70
You have been providing bag-mask ventilations to an unresponsive, apneic patient with facial trauma for approximately 10 minutes. After intubating the patient, you should:
insert an orogastric tube to relieve gastric distention.
71
If several attempts to open a patient's airway with the jaw-thrust maneuver are unsuccessful, you should:
carefully tilt the patient's head back while lifting up on the chin.
72
A patient with respiratory splinting:
is breathing shallowly to alleviate chest pain.
73
Therapeutic effects of CPAP include:
opening of collapsed alveoli.
74
Proper insertion of the LMA involves:
inserting the LMA along the roof of the mouth and using your finger to push the airway against the hard palate.
75
The most significant disadvantage associated with needle cricothyrotomy is:
The potential for pulmonary aspiration.
76
In contrast to the nasogastric tube, the orogastric tube:
is safer to use in patients with severe facial trauma.
77
When administering CPAP therapy to a patient, it is important to remember that:
the increased intrathoracic pressure caused by CPAP can result in hypotension.
78
You have intubated a 70-year-old woman with chronic bronchitis and are en route to the hospital. During transport, you note that ventilations are becoming increasingly difficult and her ETCO2 is falling. Your partner tells you that she can still hear bilaterally equal breath sounds, but they are faint. She further tells you that there are no sounds over the epigastrium. What intervention is indicated for this patient?
Tracheobronchial suctioning
79
Several cycles of basic life support maneuvers have failed to relieve a severe airway obstruction in an unresponsive 44-year-old woman. You should:
perform direct laryngoscopy and attempt to remove the obstruction with Magill forceps.
80
What point(s) on the capnographic waveform represent(s) a mixture of alveolar gas and dead space gas?
B
81
Which of the following medications is a sedative-hypnotic drug?
• Etomidate
• Fentanyl
• Alfentanil
• Ketamine
Etomidate
82
The process of delayed sequence intubation involves:
administering a sedative in order to facilitate oxygenation of the patient.
83
When administering oxygen via a nonrebreathing mask, you must ensure that the:
Patient has adequate tidal volume.
84
A young woman experienced massive facial trauma after being ejected from her car when it struck a tree. She is semiconscious, has blood draining from her mouth, and has poor respiratory effort. Appropriate initial airway management for this patient involves:
suctioning her airway until it is clear of blood and other secretions, administering a sedative and paralytic, and performing endotracheal intubation.
85
Appropriate insertion of a soft-tip (whistle-tip) suction catheter down the ET tube involves:
gently inserting the catheter until resistance is felt.
86
When looking inside a patient's mouth, you cannot see the posterior pharynx and only the base of the uvula is exposed. This is indicative of which Mallampati class?
III
87
The most significant complication associated with the use of an oropharyngeal airway is:
Soft-tissue trauma with oral bleeding.
88
A 36-year-old man experienced significant burns to his face, head, and chest following an incident with a barbeque pit. Your assessment of his airway reveals severe swelling. After administering medications to sedate and paralyze the patient, you are unable to intubate him. Furthermore, bag-mask ventilations are producing no chest rise. The quickest way to secure a patent airway in this patient is to:
Perform a needle cricothyrotomy.
89
An adult patient with an abnormal respiratory rate should:
Be evaluated for other signs of inadequate ventilation.
90
Before securing the ET tube in place with a commercial device, you should:
note the centimeter marking on the ET tube at the patient's teeth.
91
If the ET tube is placed in the trachea properly, the colorimetric paper inside the carbon dioxide detector should:
Turn yellow during exhalation.
92
Which of the following statements regarding translaryngeal catheter ventilation is correct?
Ventilation is achieved by the use of a high-pressure jet ventilator.
93
Orotracheal intubation should be performed with the patient's head:
In the sniffing position.
94
While ventilating an intubated patient, you note a complete loss of capnographic waveform and numeric value, yet the patient's chest rises with ventilations and you are able to hear bilateral breath sounds. What should you do?
Replace the ETCO2 inline adaptor.
95
A size 3 or 4 LMA:
will accommodate the passage of a 6.0-mm ET tube.
96
Paramedics must use extreme caution when accessing the airway via the cricothyroid membrane because:
The cricothyroid membrane is boarded laterally and inferiorly by the highly vascular thyroid gland
97
What phase of the capnographic waveform is called the expiratory upslope?
B-C
98
After inserting the needle into through the cricothyroid membrane, you should next:
insert the needle about 1 cm farther and then aspirate with the syringe.
99
Which of the following conditions would likely cause laryngeal spasm and edema?
• Inhalation injury
• Viral pharyngitis
• Croup
• Mild asthma attack
Inhalation injury
100
You will know that you have achieved the proper laryngoscopic view of the vocal cords when you see:
two white fibrous bands that lie vertically within the glottic opening.
101
During ventilation with the LMA, the paramedic should:
observe the patient for signs of inadequate ventilation.
102
How should the patient's head by positioned during face-to-face intubation?
It should be manually stabilized.
103
The use of capnography in patients with prolonged cardiac arrest may be limited because:
of acidosis and minimal carbon dioxide elimination.
104
Which of the following dosing regimens for ketamine would likely be used to induce sedation prior to administering a neuromuscular blocker?
2mg/kg
105
Removal of a dental appliance after intubating a patient is:
dangerous and may cause dislodgement of the tube.
106
After tracheobronchial suctioning is complete, you should:
reattach the bag-mask device, continue ventilations, and reassess the patient.
107
You are intubating a 60-year-old man in cardiac arrest and have visualized the ET tube passing between the vocal cords. After removing the laryngoscope blade from the patient's mouth, manually stabilizing the tube, and removing the stylet, you should:
inflate the distal cuff with 5 to 10 mL of air.
108
Typically, ETCO2 is approximately:
(How much higher or lower than PaCO2?)
2 to 5 mm Hg lower than the arterial PaCO2.
109
Normally, an adult male will require an ET tube that ranges from:
7.5 to 8.5 mm.
110
Placing a suction catheter past the base of the tongue:
May cause the patient to gag or vomit.
111
To prevent muscular fasciculations associated with the use of succinylcholine, you should administer:
10% of the usual dose of a nondepolarizing paralytic.
112
Laryngospasm is defined as:
Spasmodic closure of the vocal cords.
113
If the patient's oxygen saturation drops at any point during rapid sequence intubation, you should:
abort the intubation attempt and ventilate with a bag-mask device.
114
Drugs such as vecuronium bromide (Norcuron) and pancuronium bromide (Pavulon) are appropriate to administer when:
Extended periods of paralysis are needed.
115
An ET tube that is too large for a patient:
Can be difficult to insert and may cause trauma.
116
The opening on the distal side of an ET tube allows ventilation to occur:
even if the tip of the tube is occluded by blood or mucus.
117
Oxygen that is entirely devoid of moisture:
Will dry the patient’s mucous membranes quickly.
118
The pyramid-like structures that form the posterior attachment of the vocal cords are called:
Arytenoid cartilages.
119
Which of the following capnography findings indicates that a patient is rebreathing previously exhaled carbon dioxide?
Increasing ETCO2 value and waveforms that never return to the baseline
120
When checking the cuff of the LMA prior to insertion, you should:
Inflate the cuff with 50% more air than is required.
121
Endotracheal (ET) intubation is defined as:
passing an ET tube through the glottic opening and sealing off the trachea.
122
You should turn the jet ventilator release valve off when:
The patient’s chest visibly rises.
123
Which of the following factors increase a person's respiratory rate?
• Decreased metabolism
• The use of amphetamines
• The use of benzodiazepines
• Narcotic analgesic use
The use of amphetamines
124
When a patient's respirations are too rapid and too shallow:
inhaled air may only reach the anatomic dead space before being exhaled.
125
You should be suspicious of tube misplacement following a surgical cricothyrotomy if:
a crackling sensation is noted when palpating the neck.
126
The difficulty of intubation should be low if the distance between the hyoid bone and the thyroid notch is at least how many fingerbreadths wide?
2
127
You are transporting an intubated patient and note that his ETCO2 reading has fallen below 30 mm Hg. You should:
slow your ventilation rate to see if the ETCO2 reading increases.
128
It would not be appropriate to place a patient in the recovery position if they:
Are breathing shallowly.
129
Compared to orotracheal intubation, nasotracheal intubation is less likely to result in hypoxia because:
it must be performed on spontaneously breathing patients.
130
When replacing a dislodged tracheostomy tube, it is most important that you:
Take appropriate standard precautions.
131
The use of phenylephrine hydrochloride (Neo-Synephrine) during nasotracheal intubation may:
reduce the likelihood and severity of nasal bleeding.
132
Which of the following is a contraindication for nasotracheal intubation?
• Spinal injury
• Apnea
• Acetaminophen use
• Frequent use of heroine
Apnea
133
When nasally intubating a patient, the ET tube is advanced:
When the patient inhales.
134
Intubation of the trauma patient is effectively performed:
By two paramedics
135
In contrast to negative-pressure ventilation, positive-pressure ventilation occurs when:
Air is forced into the lungs.
136
Inserting a nasopharyngeal airway in a patient with CSF drainage from the nose following head trauma may:
cause the device to enter the brain through a hole caused by a fracture.
137
A disadvantage of ET intubation is that it:
bypasses the upper airway's physiologic functions of warming, filtering, and humidifying.
138
After confirming that an intubated patient remains responsive enough to maintain their airway, you should first:
Have the patient sit up or lean slight forward
139
You should insert the ET tube between the vocal cords until the:
proximal end of the cuff is 1 to 2 cm past the vocal cords.
140
Approximately 10 seconds into an intubation attempt, you catch a glimpse of the patient's vocal cords, but quickly lose sight of them. You should:
ask your partner to apply backward, upward, rightward pressure to the thyroid.
141
Which of the following medications is a dissociative anesthetic that produces anesthesia through hallucinogenic, amnesic, analgesic, and sedative effects?
• Fentanyl
• Diazepam
• Versed
• Ketamine
Ketamine
142
If a patient has a stoma and no tracheostomy tube in place:
ventilations can be performed by placing a mask over the stoma.
143
Poor lung compliance during your initial attempt to ventilate an unconscious, apneic adult should be treated by:
reopening the airway and reattempting to ventilate.
144
The Venturi mask is most useful in the prehospital setting when:
a COPD patient requires a long-range transport.
145
Which of the following interventions is not appropriate when treating an unresponsive patient whose airway is obstructed by a dental appliance?
Abdominal thrusts.
146
Which of the following patients may benefit from CPAP?
•Patient with pulmonary edema who is unable to follow verbal commands
•Alert patient with respiratory distress following submersion in water
•Trauma patient with labored breathing and extensive chest wall bruising
•Comatose patient with shallow breathing after overdosing on heroin
Alert patient with respiratory distress following submersion in water.
147
An 8-year-old child in cardiac arrest has been intubated. When ventilating the child, the paramedic should:
Deliver 10 breaths per minute.
148
Undersedation of a patient during airway management would likely result in:
Pulmonary aspiration.
149
Which of the following medications is safest to use in patients with borderline hypotension or hypovolemia?
• Pentothal
• Sublimaze
• Etomidate
• Brevital
Etomidate
150
After opening an unresponsive patient's airway, you determine that his respirations are rapid, irregular, and shallow. You should:
begin positive-pressure ventilations.
151
After the laryngoscope blade has been placed during face-to-face intubation, you may slightly adjust the patient's head to ensure better visualization by:
pulling the mandible forward by pressing down.
152
When inserting a stylet into an ET tube, you must ensure that:
the stylet rests at least half an inch back from the end of the tube.
153
You should confirm that the ET tube has passed through the vocal cords by:
visualizing the tube passing between the vocal cords.
154
Proper placement of the King LT airway is performed by using which of the following techniques?
Auscultation of bilateral breath sounds
155
Which of the following findings is clinically significant in a 30-year-old woman with difficulty breathing and a history of asthma?
Prior ICU admission for her asthma
156
Surgical cricothyrotomy is generally contraindicated in which of the following situations?
Tracheal tumors or subglottic stenosis.
157
Which of the following statements regarding oxygen is correct?
•Oxygen must be stored in a warm environment.
•Oxygen is a highly flammable gas.
•Grease prevents oxygen from exploding.
•Oxygen supports the process of combustion.
Oxygen supports the process of combustion.
158
During tracheobronchial suctioning, it is most important to:
monitor the patient's cardiac rhythm and oxygen saturation.
159
If the ET tube has been positioned properly in the trachea:
the bag-mask device should be easy to compress and you should see corresponding chest expansion.
160
When performing tracheobronchial suctioning, take care not to exceed how many seconds of suctioning in an adult?
10
161
After properly positioning the head for intubation, you should open the patient's mouth and insert the laryngoscope blade:
into the right side of the mouth and sweep the tongue to the left.
162
Which of the following is an indicator of inadequate artificial ventilation when ventilating an apneic, tachycardic adult with a bag-mask device?
About 20 breaths per minute are being delivered.
163
You are caring for a 69-year-old man with congestive heart failure. His breathing is profoundly labored, his oxygen saturation reads 79% on oxygen via nonrebreathing mask, and he is showing signs of physical exhaustion. Considering that your protocols do not allow you to perform rapid sequence intubation, you should:
preoxygenate him with a bag-mask device and then perform blind nasotracheal intubation.
164
Biot respirations are characterized by:
an irregular pattern of breathing with intermittent periods of apnea.
165
Surgical cricothyrotomy is indicated when:
you are unable to secure a patent airway with less invasive means.
166
Reemergence phenomenon is characterized by:
pleasant dreams or vivid nightmares.
167
Which of the following is a complication associated with orotracheal intubation?
•Laryngeal swelling
•Aspiration
•Traumatic brain injury
•Necrosis of the nasal mucosa
Laryngeal swelling
168
Complications associated with the one-person bag-mask ventilation technique are often related to:
inadequate tidal volume delivery.
169
When performing surgical cricothyrotomy, you should first:
Palpate for the V notch of the thyroid cartilage and stabilize the larynx.
170
Hyperventilating an apneic patient:
may decrease venous return to the heart.
171
Which of the following patient characteristics can help you determine which size King LT airway to use?
•Height and weight
•Level of consciousness
•Age
•Gender
Height and weight
172
In order for a tracheostomy tube to be compatible with a mechanical ventilator or bag-mask device:
it must be equipped with a 15/22-mm proximal adaptor.
173
If return of spontaneous circulation (ROSC) occurs, which of the following ETCO2 findings would you expect to encounter?
An abrupt and sustained increase in ETCO2
174
Proper insertion of the needle into the cricothyroid membrane involves which angle toward the patient's feet?
45 degrees.
175
In which of the following conditions would you likely encounter pulsus paradoxus?
Pericardia tamponade
176
When using the King LT airway, too much air in the oropharyngeal cuff could result in:
Increased intracranial pressure.
177
If chest compressions and repositioning of the airway are unsuccessful in removing a severe airway obstruction in an unconscious patient, you should:
perform laryngoscopy and use Magill forceps.
178
When determining the correct-sized nasogastric tube for a patient, you should measure the tube:
from the nose to the ear and to the xiphoid process.
179
The procedure in which the vocal cords are visualized for placement of an ET tube is called direct:
Laryngoscopy
180
The pulse oximeter is useful when:
Identifying deterioration of the cardiac patient
181
Decreased ventilation compliance following intubation may suggest:
Gastric distention
182
If ventilation is difficult after inserting a King LT airway, you should:
gently withdraw the device, without deflating the cuffs, until ventilation is easier.
183
Which of the following is a step that is performed during nasotracheal intubation?
•Ensuring that the patient's head is hyperflexed
•Inserting the tube into the right side of the patient's mouth
•Advancing the tub as the patient exhales
•Preoxygenating with a bag-mask device as necessary
Preoxygenating with a bag-mask device as necessary
184
The LMA is:
an alternative to bag-mask ventilation when intubation is not possible.
185
The paramedic should be especially diligent when confirming tube placement following blind nasotracheal intubation because:
they did not visualize the tube passing between the vocal cords.
186
Needle cricothyrotomy is contraindicated in patients with:
Obstruction above the catheter insertion site
187
When performing surgical cricothyrotomy, you can avoid damage to the jugular veins if:
the cricothyroid membrane is incised vertically.
188
When performing face-to-face intubation, advance the ET tube until the cuff is about how many inches past the vocal cords?
0.5 to 0.75 inches
189
After placing an ET tube, you suspect that the filter line from the capnography adaptor is occluded by blood or other secretions. What should you do in this situation?
Replace the in-line ETCO2 detector.
190
How does the i-gel differ from the LMA?
The I-gel has a non inflatable mask.
191
Which of the following is a complication of aspiration?
•Airway obstruction
•Excess surfactant production
•Severe bradycardia
•Damage to the vocal cords
Airway obstruction.
192
Before intubating a patient who has been chemically sedated and paralyzed, it is most important for the paramedic to:
adequately preoxygenate with 100% oxygen.
193
Regardless of the internal diameter, all ET tubes have:
A 15/22 mm proximal adaptor.
194
If an unresponsive patient does not have a gag reflex, an oropharyngeal airway:
should be inserted whether the patient is breathing or not.
195
Neuromuscular blocking agents:
Convert a breathing patient with a marginal airway into a Apneic patient with no airway
196
The average peak expiratory flow rate in a healthy adult is approximately:
550 mL.
197
Which of the following statements regarding field extubation is correct?
It is generally better to sedate the patient than to extubate.
198
Capnography is a reliable method for confirming proper ET tube placement because:
carbon dioxide is not present in the esophagus.
199
The concept of apneic oxygenation is based on the fact that:
Oxygen uptake by the alveoli with continue, even when the diaphragm is not moving
200
The most obvious risk associated with extubation is:
overestimating the patient's ability to protect their airway.
201
Which of the following is proper procedure when inserting a nasogastric tube in a responsive patient?
Administering a topical alpha agonist to constrict the nasal vasculature.
202
You are dispatched to the residence of a 19-year-old man who has a tracheostomy tube and is on a mechanical ventilator. According to the patient's mother, he began experiencing difficulty breathing about 30 minutes ago. Auscultation of his lungs reveals bilaterally diminished breath sounds, and his oxygen saturation is 80%. You disconnect the patient from the mechanical ventilator and begin bag-mask ventilations; however, you meet significant resistance. You should:
remove the bag-mask device and suction his tracheostomy tube.
203
Compared with surgical cricothyrotomy, needle cricothyrotomy:
Allows for subsequent attempts to intubate the patient.
204
A 19-year-old woman ingested a large quantity of Darvon. She is responsive to pain only and has slow, shallow respirations. Appropriate airway management for this patient involves:
inserting a nasal airway and assisting ventilations with a bag-mask device.
205
The most significant complication associated with the use of an oropharyngeal airway is:
soft-tissue trauma with oral bleeding.
206
Signs of clinical improvement during CPAP therapy include:
increased ease of speaking.
207
It would be appropriate to insert a nasopharyngeal airway in patients who:
have an altered mental status with an intact gag reflex.
208
Which of the following would likely cause a prolonged alveolar plateau?
Heroin overdose.
209
A decrease in which of which of the following decreases carbon dioxide elimination, resulting in a building of carbon dioxide in the blood?
Minute volume
210
On a capnographic waveform, which point is the maximal ETCO2 and is the best reflection of the alveolar CO2 level?
D
211
A patient with orthopnea:
Has dyspnea while lying flat.
212
Whether you are providing ventilations to a patient with a stoma using a resuscitation mask or bag-mask device, you must first:
place the patient's head in a neutral position.
213
Asymmetric chest wall movement is characterized by:
one side of the chest moving less than the other.
214
A Cormack-Lehane Class 3 airway is characterized by:
visualization of the epiglottis only.
215
When a patient is given a paralytic without sedation
They are fully aware and can hear and feel
216
When a patient is given a paralytic without sedation
They are fully aware and can hear and feel
217
If you see a soft-tissue bulge on either side of the airway when performing nasotracheal intubation:
you have probably inserted the tube into the piriform fossa.
